時間調節誘導化療聯合調強放療同期洛鉑化療治療局部晚期頭頸部鱗癌的效果

郭立儀 鄧明輝 呂莉

[摘要]目的 探討局部晚期頭頸部鱗癌患者臨床聯合接受時間調節誘導化療、調強放療同期洛鉑化療的臨床效果。方法 選取2014年4月～2017年4月我院的60例局部晚期頭頸部鱗癌患者作為研究對象，采用隨機分組方法將其分為觀察組和對照組，各30例患者。對照組接受時間調節誘導化療，觀察組聯合接受時間調節誘導化療、調強放療同期洛鉑化療，比較兩組的不良反應發生率、總有效率、1年內總生存率、無進展生存率以及無局部復發生存率。結果 觀察組的總有效率為60.00%，高于對照組的30.00%，差異有統計學意義（P<0.05）。觀察組的不良反應總發生率為23.33%，與對照組的20.00%比較，差異無統計學意義（P>0.05）。觀察組的治療后1年內總生存率、無進展生存率以及無局部復發生存率分別為80.00%、60.00%、56.67%，高于對照組的53.33%、33.33%、30.00%，差異有統計學意義（P<0.05）。結論 時間調節誘導化療聯合調強放療同期洛鉑化療治療局部晚期頭頸部鱗癌效果滿意，不良反應程度較輕，患者能夠耐受，具有臨床應用價值。

[關鍵詞]局部晚期頭頸部鱗癌;時間調節誘導化療;調強放療;同期洛鉑化療;治療

[中圖分類號] R739.91 ? ? ? ? ?[文獻標識碼] A ? ? ? ? ?[文章編號] 1674-4721（2019）1（b）-0068-03

[Abstract] Objective To investigate the clinical effect of combined time-modulated induction chemotherapy and intensity-modulated radiotherapy with concurrent lobaplatin chemotherapy in locally advanced head and neck squamous cell carcinoma. Methods Altogether 60 patients with locally advanced head and neck squamous cell carcinoma from April 2014 to April 2017 were selected and randomly divided into the observation group and the control group， 30 cases in each group. The control group was treated with time-modulated induction chemotherapy. The observation group was treated with time-modulated induction chemotherapy and intensity-modulated radiotherapy combined with concurrent Lobaplatin chemotherapy. The incidence of adverse reactions， total effective rate， one-year overall survival rate， progression-free survival rate and local recurrence-free survival rate were compared between the two groups. Results The total effective rate of the observation group was 60.00%， which was higher than that of the control group （30.00%）， with statistically significant difference （P<0.05）. The total incidence of adverse reactions of the observation group was 23.33%， compared with the control group （20.00%）， there was no statistically significant difference （P>0.05）. The one-year overall survival rate， progression-free survival rate and local recurrence-free survival rate of the observation group were 80.00%， 60.00% and 56.67% respectively， which was higher than those of the control group （53.33%， 33.33% and 30.00%）， with statistically significant difference （P<0.05）. Conclusion Time-modulated induction chemotherapy combined with intensity-modulated radiotherapy combined plus concurrent Lobaplatin chemotherapy for locally advanced head and neck squamous cell carcinoma has a satisfactory effect with mild adverse reactions， which can be tolerated by patients and has clinical value.